End Medicaid as we know it, potentially saddling states with new health care costs by placing a cap on what the federal government pays them for each person covered by their Medicaid program. This cap will hinder states’ ability to cover unexpected health care costs, like covering newly released innovative medications that are expensive (e.g., the direct acting antivirals that cure hepatitis C), or responding to novel disease breakouts. More about why per-capita caps are a bad idea.

Substantially reduce the premium subsidies that help millions afford insurance through health exchanges. The proposals end financial assistance for 6.3 million lower-income people that helps them reduce their out-of-pocket costs, such as deductibles. Many of these people could see their deductibles increase by as much as $5,500. People with chronic illnesses will be hurt the most, left with only bare-bones coverage that comes with drastically higher deductibles. These individuals will once again be forced to go without lifesaving treatment or go into debt to get the care they need.

Require people to maintain “continuous coverage” or pay more in premiums. While the Republican proposal does preserve the all-important provision from the Affordable Care Act for coverage of pre-existing conditions, it requires that people maintain continuous insurance coverage or be subject to 30 percent increases in their premiums. This provision intentionally leaves people unable to purchase insurance. Maintaining continuous coverage can present a severe challenge for people who enter and leave the employment market, or have other challenges to remaining insured.

Change health savings accounts (HSAs) in ways that would only help the wealthy. The financial assistance in this bill is so inadequate that most lower- and moderate-income people will struggle to afford premiums for the plan they have today. HSAs don’t work for most households, especially those living paycheck to paycheck and who can’t afford to set aside thousands of dollars to pay the full cost of their health care bills. This bill would just open the door for wealthy people to stash more money in these accounts to avoid paying taxes. The majority of individuals who actually put money into HSA’s live in households making more than $100,000 each year.

Repeal provisions in the ACA that improve access to behavioral health services, like substance use treatment and mental health services. These services are critical to preventing and responding to outbreaks of HIV, hepatitis C, overdose, and other conditions.

End funding for Planned Parenthood. Many people at risk for HIV and hepatitis C receive preventive services, like PrEP (HIV pre-exposure prophylaxis), condoms, STD testing and treatment, HIV and hepatitis C testing and linkage to care services at Planned Parenthood.

Eliminate the Prevention & Public Health Fund. This fund provides expanded and sustained national investments in prevention and public health to improve health outcomes and enhance health care quality. Of note, the Prevention & Public Health Fund supports state, local, and territorial health departments’ capacities for detecting and responding to infectious diseases, such as hepatitis C and HIV, and other public health threats.

We don’t know the bill’s full impact on the federal budget. In a highly irregular move, House Republicans are rushing this bill through committees without releasing a formal cost estimate from the nonpartisan Congressional Budget Office (CBO), which analyzes how much federal legislation will cost or save American taxpayers—known as a “score.”

What you can do: Contact your representatives

Call 866-426-2631

Use this toll-free line provided by our friends at SEIU. Here are sample messages:

Lawmakers should not vote on the bill until they know the impact it will have on the federal budget and, more importantly, the more than 20 million people who have gained coverage under the Affordable Care Act.

Demand that lawmakers follow the normal procedures, hold formal hearings, and wait to vote until the Congressional Budget Office (CBO) reviews the bill and gives it a score.

HCV Education
Review learning activities, editorials, with new data about interferon-free regimens approved for HCV, as well as investigational drugs still in the pipeline. Links are provided to support, patient friendly information, clinical trials, peer-reviewed journals, videos, conferences with commentary, all updated on a continuous basis.

Users can search for a hepatitis C clinical trial by category (genotype), or learn how to evaluate a clinical trial and become familiar with commonly used terms. HCV Advocate offers an easy to navigate HCV Medications Blog as well, organized by HCV genotype

View each rebuttal and all ongoing media coverage. In June the HCV community was blindsided when an article with a somewhat "clickbait" headline was released by The Guardian. The Guardian reported on a systematic review published by the Cochrane Collaboration that suggested achieving SVR (cure) for patients using hepatitis C direct-acting antivirals (DAAs) doesn't correlate with any long term benefits.

The controversy over expensive new drugs for hepatitis C
Link to research and news articles addressing the high cost of hepatitis C drugs; insurance restrictions - private insurers/Medicaid - and availability of generic versions/India, Egypt and other lower-income countries or through online "buyers clubs"

Liver Cancer After Treatment For Hepatitis C
​Research demonstrates that while SVR markedly reduced liver-related complications and liver cancer, some long-term risk for liver cancer remained in those who were cured of Hepatitis C. But after direct-acting antiviral therapy does the risk of developing liver cancer increase?

Meeting Updates

April 19-23
The European Association for the Study of the Liver (EASL) International Liver Congress (ILC 2017)

Merck today announced its strategic decision to discontinue the development of the investigational combination regimens MK-3682B (grazoprevir/ruzasvir/ uprifosbuvir) and MK-3682C (ruzasvir/uprifosbuvir) for the treatment of chronic hepatitis C virus (HCV) infection. This decision was made based on a review of available Phase 2 efficacy data and in consideration of the evolving marketplace and the growing number of treatment options available for patients with chronic HCV infection

Two HCV Drugs to Be Discontinued
The Food and Drug Administration (FDA) announced that Rebetol(ribavirin; Merck) capsules and PegIntron (peginterferon alfa-2b; Merck) for Injection are being discontinued. The decision is business-related and not due to safety or efficacy issues with the drugs.

Rebetol is a nucleoside analogue indicated for chronic hepatitis C in combination with interferon alfa-2b (pegylated and nonpegylated), in patients ≥3 years of age with compensated liver disease. It is supplied as 200mg capsules in 56-, 70-, and 84-count bottles. The Rebetol discontinuation is effective February 1, 2016.
PegIntron is an antiviral indicated for treatment of chronic hepatitis C in patients with compensated liver disease. It is supplied as 50mcg/0.5mL, 80mcg/0.5mL, 120mcg/0.5mL, and 150mcg/0.5mL single-use vials and single-use pre-filled pens. No effective date is available for the PegIntron discontinuation.

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